Remember the uninsured?

By
Ezra Klein

In February 2007, Deamonte Driver died of an infected tooth. But he didn't really die of an infected tooth. He died because he didn't have consistent insurance. If he'd had an Aetna card, a dentist would've removed the tooth earlier, and the bacteria that filled the abscess would never have spread to his brain.

Deamonte Driver was 12. His insurance status wasn't his fault.

If all you knew about the Affordable Care Act was what you gleaned from watching the Republicans make their case against it, you probably would not know that the legislation means health-care coverage for more than 30 million Americans. Or, if you did know that, you'd be forgiven for not realizing it's relevant: It almost never gets mentioned (see this congressman's rundown of the bill's contents, for instance), and the repeal legislation the Republicans are pushing does nothing to replace the coverage the Affordable Care Act would give to those people.

The lack of concern for how more than 30 million Americans will get their health-care coverage makes for an ugly contrast with the intense concern that Rep. Andy Harris -- a proponent of repeal -- found when he heard that his congressional health-care coverage wouldn't begin until a month after he took the oath of office. "He stood up and asked the two ladies who were answering questions why it had to take so long, what he would do without 28 days of health care," recalled one of the session's attendees. He knows his taxpayer-subsidized insurance is important. But what about Driver's?

We have a tendency to let the conversation over health-care reform become a bloodless, abstract discussion over cost curves and CBO models. We do that for two reasons: First, cost is important. Second, it's important to the people who have political power, which is, by and large, not the same group who doesn't have health-care insurance. Someone involved in the 2008 campaign once told me he'd seen numbers showing that 95 percent of Obama's voters were insured. The numbers for McCain were, presumably, similarly high, or even higher. These are the people the political system is responsive too.

But that doesn't make the plight of the uninsured any less wrenching. The Urban Institute estimated that 22,000 people died in 2006 because they didn't have health-care insurance. John Ayanian, a professor of medicine and health-care policy at Harvard Medical School, testified before Congress on this issue. “Uninsured adults are 25 percent more likely to die prematurely than insured adults overall," he said, "and with serious conditions such as heart disease, diabetes or cancer, their risk of premature death can be 40 to 50 percent higher.” And none of that takes into account the unnecessary suffering and physical damage that flourishes in the absence of effective medical care. Nor does it speak to the economic devastation that illness unleashes on uninsured families.

These numbers shouldn't surprise us: We pay a lot of money for health-care insurance. We've directed the government to spend even more money subsidizing that insurance for the elderly, the disabled, some of the poor and everyone who gets health-care coverage through their employer. We value this product so highly for a reason: Most of us would agree that being able to afford to see a doctor isn't a luxury. It's a necessity. Rep. Harris certainly feels that way.

The same goes for the uninsured. In fact, it's often more true for them, as many haven't received reliable care for some time and have multiple health problems that haven't been effectively treated. That's why, when a temporary free clinic set up shop in Los Angeles, 3,000 people lined up for treatment. It's why the famed RAND health insurance experiment found the people who benefited from insurance most clearly were the poor, as they were often plagued by easy-to-treat conditions like hypertension.

The Affordable Care Act covers the vast majority of the uninsured. It covers everyone who makes less than the poverty line, and almost everyone who makes less than 300 percent of the poverty line. It does all this while spending about 4 percent of what our health-care system currently spends in a year, and it offsets that spending -- and more -- to make sure the deficit doesn't bear the burden of society's compassion. Perhaps there's a better way to achieve those goals that can pass Congress. If so, I'm open to hearing about it. But to repeal the bill without another solution for the Deamonte Drivers of the world? And to do it while barely mentioning them? We're a better country than that. Or so I like to think.

So because this poor kids mother would not shell out the $80.00 needed to save her sons life, then as a country we should spend a trillion dollars to give more people health insurance? Do you really believe that when more people have insurance that things like this won't happen anymore?

I think it is enlightening that when the Democratic Party sends out a directive to start talking about personal stories relating to the benefits of ObamaCare, Ezra quickly complies.

to cummije5. Actually, I think the best thing to do would be to outlaw insurance period and just make everyone pay their dr. directly. If they can't afford to then they should let them die. Eventually, you'd have a healthy population and you wouldn't have to worry about too many people. We're making this too difficult. Rush doesn't have health insurance. He pays for everything himself.

"In February 2007, Deamonte Driver died of an infected tooth. But he didn't really die of an infected tooth. He died of not having decent or consistent health-care coverage. If he had been covered by health insurance, a dentist would've taken the tooth out earlier, and the bacteria that filled the abscess would never have spread to his brain."

In otherwords, Medicaid isn't decent or consistent health insurance, as that's what he was covered by. Good to know.

"Reimbursement rates for dentists remain low nationally, although Maryland, Virginia and the District have increased their rates in recent years."

"Dentists also cite administrative frustrations dealing with the Medicaid bureaucracy and the difficulties of serving poor, often transient patients, a study by the state legislatures conference found."

"The federal government requires states to provide oral health services to children through Medicaid programs, but the shortage of dentists who will treat indigent patients remains a major barrier to care, according to the National Conference of State Legislatures."

"In spite of efforts to change the system, fewer than one in three children in Maryland's Medicaid program received any dental service at all in 2005, the latest year for which figures are available from the federal Centers for Medicare and Medicaid Services."

That's your socialized medicine for you. Didn't mean a damn thing when lives were at stake.

No one claimed health care reform would end all suffering it the world, but it's indisputable that it will save thousands, probably tens of thousands of lives each year. Many of them children.

I don't know which dentist you go to where getting a tooth extracted costs just $80. At mine a 15 minute cleaning costs $100, and it's done entirely by the dental hygienist. The simplest procedure will cost at least $200. More if you're a new patient.

I'm sure Ezra saw the many articles that have poked holes all over the liberal contention of how many millions were uninsured. Based solely on the facts given, I'm guessing this young man may have been part of the 8 million (I think that was the number) that are included in Democrats claims as to who gets access to care now thanks to the ACA....but who already qualified for existing state programs but either didn't know about them, or didn't take advantage of them.

Fact remains....Ezra's protestations to the contrary, the ACA does not expand health care access to one single poor person vs what they could previously obtain. It merely centralizes control of the funding mechanism.

But I'm sure such facts won't stop Ezra from continuing his quest to convince people of the millions upon millions of poor and downtrodden who are now saved thanks to the ACA, who otherwise would have been left dying in the gutters of our fair land.

"If all you knew about the Affordable Care Act was what you gleaned from watching the Republicans make their case against it, you probably would not know that the legislation means health-care coverage for more than 30 million Americans."

Much of that coverage increase comes via Medicaid, which has been shown in this post to be indecent and inconsistent health care coverage. The very same program which spent $250,000 on a failed attempt to save a kid because the bureaucrats couldn't figure out the correct reimbursement rate for dental procedures.

Maybe if half of their incomes weren't taken in taxes, dentists might not mind taking on the occassional pro-bono case, or offerring deeply discounted services to lower income clients.

"The lack of concern for how more than 30 million Americans will get their health-care coverage..."

And once again, Ezra lays the progressive trap for weak-thinking individuals....'compassion' equals support for big-government programs, and any solution that doesn't involve more centralized government control and/or a new bureaucracy is no solution at all.

I wonder what all the conservatives who have given large amounts of money for years (more than their liberal counter-parts, to be sure) to fund hospitals and non-profit health clinics think when they hear Ezra libel them as 'not caring for the uninsured' simply because they didn't support Obamacare?

I know Ezra believes the uninsured never had the opportunity to see a doctor or nurse before the ACA. I would love to take him to a clinic my relative runs that's been caring for these poor individuals for years, funded mostly by the conservatives Ezra routinely demonizes as 'uncaring'....

"Uh, that's because under Medicaid states are not required to offer dental coverage. A few states do with their own money, but most don't.

Nice try though."

dstr,

Try reading the article (or even the quotes I provided). Here it is again - I'll even take out the irrelevant parts:

"The federal government requires states to provide oral health services to children through Medicaid programs"

Here's another one, if you're still with me:

"Norris and her staff also ran into barriers: They said they made more than two dozen calls before reaching an official at the Driver family's Medicaid provider and a state supervising nurse who helped them find a dentist."

The issue was that there was a shortage of dentists willing to accept Medicaid patients. The mother started calling Medicaid in September and couldn't get anything scheduled until January. Another side issue is that Medicaid, despite being used by a lot of fairly transient people, (presumably) mailed the paperwork to a previous address, received no response, and coverage was dropped.

its amazing because if an insurance company dropped someone this would be front page news. This story is absolutely horrible. But the problem is Ezra it only give us another example of why government run is NOT the answer.

What's the point of this post? The ACA doesn't mean it will be easier to get a dentist on Medicaid.

With the additional burdens of the ACA, fewer doctors are going to be available to take Medicaid patients (and Medicare patients).

Insurance regulation in this country is broken. We need to encourage plans that save money, not plans that make everything cost more. Then we'll have enough money to ensure everyone can get some coverage.

Thank you, Ezra, it's nice to see SOMEONE in the media put this issue on the table.

Throughout the healthcare debate, I was just awestruck at how little attention was made of the fact that this reform would EXPAND healthcare to people who couldn't afford it. I've been paying my own insurance for over a decade. I'm lucky enough that I got into the individual market at a young age, without any pre-existing conditions, and I'm in a market (Cleveland) where there are a lot of options. But the premium costs keep rising, and the deductibles keep rising, and the co-insurance keeps rising, and the things not covered keep rising. So, I'm forking over $4,000 a year for this policy, and if I think something is wrong with me I wait and wait and wait and wait, because I have to basically pay for anything I would have done.

A couple years ago, I made the mistake of going in to see the doc after I had all kinds of pain in my neck and back. Everything resolved itself. Everything except the $300 blood test, which magically wasn't covered by my insurance or even applied against the deductible because the doctor added a "routine" cholesterol component to the test. So, go see a doc, get any of the normal diagnostic screenings, and you basically get to pay -- OUT OF POCKET -- what you'd shell out for a new dishwasher that will work every day for you for a decade.

Ezra, can you please (the next time you're on TV) give the Kaiser Foundation web address for the calculator that allows people to see what kind of assistance they'd get in paying for their premiums if the repeal doesn't happen, and if they get the help they're scheduled to get.

It just blows my mind to hear every Democrat on TV talk about kids getting healthcare, and closing the doughnut hole of the Medicare prescription drug coverage, and eliminating pre-existing condition restrictions, and letting 20-somethings stay on their parents' coverage ... and nobody EVER talks about the subsidies, and the calculator that would allow people who pay their premiums + their out of pocket deductibles, co-insurance, etc, etc, etc to actually AFFORD some healthcare at the end of the day.

Nobody who gets to go on TV is in a position of not having their healthcare paid for by someone else. And it would sure be nice if this view got aired in the half-decade that this issue has been on the airwaves.

The thing is, Ezra is informed enough to know everything justin84 said. I don't like to make accusations of bad faith, but seriously, Ezra knows the story of Deamonte Driver is much more nuanced than he makes it out to be, and is in fact quite damning of Medicaid. Why would he trot out this weak sauce if not to intentionally mislead?

David Frum wrote on the WaPo Driver Story three years ago: "In conformity to the most ancient canons of liberal advocacy journalism, reporter Mary Otto has ignored the real story - a shocking account of parental incompetence and neglect - to advance an agenda."

It's always interesting to see all these supposedly "pro-life" conservatives rush here to complain whenever Ezra posts something supporting healthcare reform. What's even sadder is that, despite the issue essentially being one of protecting human life, they base their arguments not in an opinion of their being a better way, but rather on partisan politics or some form of liberal-bashing.

no @charri68, what's interesting is that you think people who disagree with Ezra on health reform must be "pro-life conservatives".

We are basing this argument on "partisan politics" because Ezra dredging up this very old story that was an example of the problems with government run health care as well as parental neglect is itself shameless partisan politics.

My friend in Australia is a nurse midwife at her local community clinic. She sees the baby in the hospital after the baby is born , that is the start of the record. Then every few weeks , months and years the baby comes for shots , testing , Pediatrician visits , then the record is sent on to the school, If the family moves the record is sent to the other community . At risk children are identified early. If the child is no show , there is a home visit .
It was so nice to walk down the street with my friend and see her greeted warmly by mothers with strollers... this is a big city by the way , Melbourne . Health care can be done in a sane and efficient manner , and it need not cost a fortune .

The myopia of those who choose to pick at the details of the Deamonte Driver anecdote miss the larger point Ezra makes.

Small health issues, left untreated, can become major health problems, and can even turn lethal.

Millions of America's working poor earn too much to qualify for Medicaid (budgets for which are being slashed in many states), but on the other hand these same folks do not receive employer subsidized health benefits and they cannot afford to purchase individual policies. Hence millions of Americans ARE without affordable access to basic primary health care.

Taking steps to provide access to affordable care is not only a choice that any humane society would make, it also helps ensure that a problem that can be resolved early at relatively low cost does not turn into an emergency room situation requiring expensive intervention later on, reulting in the addition of significant preventable costs to be passed on to others.

The tedium of these predictable "gotcha" objections to the circumstances of a particular anecdote are a good example of why I have not bothered to post here for a number of months.

Patrick_M, you're missing the point. Anecdotes are silly ways to advance your desired policy preferences, and in this case the anecdote is meaningless. He had coverage through Medicaid, which proved to be inadequate because of his mother's incompetence and bureaucratic failure. For all of Ezra's supposed concern about the uninsured, most of the coverage expansion in PPACA is through Medicaid. Nothing in PPACA would have improved Deamonte Driver's situation.

To call this reaction myopic is completely backwards. If anything the Deamonte Driver story suggests that expanding Medicaid is a bad idea.

I wonder how many Dentists (and other doctors) have been disincentivized (is that a word?) out of pursuing their avocations by fifty years of overbearing government pay caps, regulatory burdens, and outright competition from the 900lb gorilla who refuses to pay market rates? Could it be that it's hard to find a dentist who's inclined to throw some free treatment to a kid with rotten teeth because they've all already had their means of livelihood cut to the bone by busybody meddling looters wanting to chip off their own piece of another person's success? How much extra charity can a dentist show, when these giant government programs of forced "charity" have already sucked the benevolence of him?

And you, Patrick, you moron, maybe even you could afford to treat some kid to a free dental visit, were it ever to occur to you to put your own dollars where your mouth is, if the government weren't already redistributing your dollars for you in that big ol' friendly, incompetent, corrupt way it has.

See ya. Have fun at Yglesias's propagandic fun park of lies and bigotry.

Klein has been for a government-controll HC scheme all along. This is why he continues to claim that there are 30 million uninsured when there are only 6 to 10 million uninsured who aren't illegal aliens, covered by other govt. programs or gaming the insurance markets because they don't want to buy insurance they can afford.

In February 2007, Deamonte Driver died of an infected tooth. But he didn't really die of an infected tooth. He died because he didn't have consistent insurance. If he'd had an Aetna card, a dentist would've removed the tooth earlier, and the bacteria that filled the abscess would never have spread to his brain.

Deamonte Driver was 12. His insurance status wasn't his fault.
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PSSSST, Ezra. The kid did "not" die of an infected tooth, or because of the lack of Insurance, of any type. He died of parental neglect.
Did he have parents, that are still alive? Why did they "not" take Deamonte to their nearest Dentist, and hock their X-BOX, Cell Phones, Big Screen TV, and all other Electronics, in the house?
You've apparently researched the story. How much money, did the local Dentist, require, to treat, or remove the infected tooth? What does the "normal" or average Dental visit cost, in the area in which Deamonte lived?
I paid my Vet, $369.00 to remove my dogs tooth. I'd have paid more, if necessary. How much was the kids life, worth to his parents?
No, Ezra. Deamonte Driver did "not" die from a lack of Insurance. He was neglected. I think someone responsible, should be brought up, on charges.
Dennis

In February 2007, Deamonte Driver died of an infected tooth. But he didn't really die of an infected tooth. He died because he didn't have consistent insurance. If he'd had an Aetna card, a dentist would've removed the tooth earlier, and the bacteria that filled the abscess would never have spread to his brain.

Deamonte Driver was 12. His insurance status wasn't his fault.
-------------------------------------------
PSSSST, Ezra. The kid did "not" die of an infected tooth, or because of the lack of Insurance, of any type. He died of parental neglect.
Did he have parents, that are still alive? Why did they "not" take Deamonte to their nearest Dentist, and hock their X-BOX, Cell Phones, Big Screen TV, and all other Electronics, in the house?
You've apparently researched the story. How much money, did the local Dentist, require, to treat, or remove the infected tooth? What does the "normal" or average Dental visit cost, in the area in which Deamonte lived?
I paid my Vet, $369.00 to remove my dogs tooth. I'd have paid more, if necessary. How much was the kids life, worth to his parents?
No, Ezra. Deamonte Driver did "not" die from a lack of Insurance. He was neglected. I think someone responsible, should be brought up, on charges.
Dennis

The myopia of those who choose to pick at the details of the Deamonte Driver anecdote miss the larger point Ezra makes.

Small health issues, left untreated, can become major health problems, and can even turn lethal.

Millions of America's working poor earn too much to qualify for Medicaid (budgets for which are being slashed in many states), but on the other hand these same folks do not receive employer subsidized health benefits and they cannot afford to purchase individual policies. Hence millions of Americans ARE without affordable access to basic primary health care.

Taking steps to provide access to affordable care is not only a choice that any humane society would make, it also helps ensure that a problem that can be resolved early at relatively low cost does not turn into an emergency room situation requiring expensive intervention later on, reulting in the addition of significant preventable costs to be passed on to others.

The tedium of these predictable "gotcha" objections to the circumstances of a particular anecdote are a good example of why I have not bothered to post here for a number of months.

Posted by: Patrick_M | January 19, 2011 7:24 PM | Report abuse
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Patrick, I'm sorry. The kid did "not" die, due to lack of Insurance.
He died from parental neglect.
Did Deamonte have parents?
Where were they, and what were they doing? The kid was 12 years old. They typical 12 year old, has at least two Electronic games, X-Box, WII, Play Station, etc, that cost more than two Dental visits, or extractions.
Did the parents care more about Deamonte's entertainment needs, than his health, well being, and life??
Dennis

"The myopia of those who choose to pick at the details of the Deamonte Driver anecdote miss the larger point Ezra makes."

Exactly. All that was claimed is that inconsistent access to health care can be a serious problem--it's the only good that the government will provide to you sometime in the future even if you cant pay. Since conservative compassion, free-market principles have done a horrible job for the past few decades providing such an important good, the ACA was the result.

"Exactly. All that was claimed is that inconsistent access to health care can be a serious problem--it's the only good that the government will provide to you sometime in the future even if you cant pay."

oAGubFB,

Only, it was too far in the future to be of any good to Deamonte Driver.

"Since conservative compassion, free-market principles have done a horrible job for the past few decades providing such an important good, the ACA was the result."

There hasn't been a free market in health care for quite a few decades now.

Don't forget, Ezra is using a Medicaid failure to sell a program that adds quite a few people to Medicaid.

"Causation is complex, it doesn't have to be one thing. Do you think he would have died in a single payer system where one need only walk into a doctors office to receive care?"

If underpayment of dentists restricts supply (as in the linked article), then yes, Driver would have died no matter how many people were on the government health plan.

I guess it all depends on which of the many articles you want to believe. For the hard-nosed unsympathetic conservatives, there is many a blog and many a website putting the blame squarely in the mother's hands for not seeking proper treatment, for not having insurance, for not having $80. For the sympathetic, bleeding-heart liberals, it was a matter of the mother having another son with six cavities she was more worried about, the fact that she had lost her health insurance, the idea that her Medicaid had been cancelled (or at the very least she couldn't locate a dentist that would accept Medicaid). But it got way more expensive before he died, because he underwent two surgeries and spent six weeks in the hospital with doctors trying to save his life. I guess that leaves me a bleeding-heart liberal, because I think this country, when it comes to kids, should always err on the side of mercy and compassion, NO MATTER HOW MUCH IT COSTS. We can spend massive amounts of money on wars and making sure the rich are not over-taxed, but to allow one child to come into harm's way for lack of medical care is indefensible. The conservatives concern themselves with the rights of the unborn, but consider me one liberal who is more concerned with the rights of a child once it is born and on this earth. Whether the parents are the greatest or the worst, whether the kids are planned or not, every child on this earth certainly cannot help the fact that he or she is here. And if our country is as religious and compassionate as we advertise to the rest of the world, no child should ever die for lack of medical care. Or lack of $80 for a dental extraction.

So Deamonte Driver's parents couldn't afford a consistent health plan, and for some reason weren't inclined to utilize Medicaid, which is there for just that reason. What then, under Obamacare, would make it possible for the parents to afford either Aetna or the "state exchange" equivalent, or the tax penalty for failing to purchase either? As logical arguments go, Ezra, this one's a loser.

And immaterial, at that. Even if Obamacare delivered everything promised - an impossibility, of course, but let's fantasize - it would still be an unconstitutional intrusion into our personal lives by a faceless, soulless, bureaucratic federal government. And young Driver, unfortunately, would still be dead. So quit trying to use his memory for your own ends.

Just another poor kid killed by the collectivist disease masquerading as compassion. The parents outsourced their compassion to a cold and calculating bureaucracy. They should have fix their boys tooth. Liberals don't know compassion, they only know government threft and redistribution, and blaming the obvious outcomes on their political opponents. Ezra, you are slime, and so is your ideology.

Part of the problem of trying to have a productive discussion is that you need to start with some common ground in reality. In this debate, we start with things like "the legislation means health-care coverage for more than 30 million Americans". We know where the number comes from - there are about 40-45million uninsured in the country and between 10-15million are illegal immigrants not covered by the bill, this leaves 30million uninsured who might be covered by a bill. We understand this number and we know it is wrong. Many of the uninsured are already elligible for medicaid, so this bill does nothing for them. Many can afford insurance but don't think it is worth it, this bill makes it more expensive for them and forces them to buy it. That is not a benefit. So we know the statement is wrong, not a different opinion - just wrong, but we keep trying to base a discussion on it. Of course we keep failing.

Second - the example. In the initial description the author uses health care and health insurance interchangeably. They are not the same. The particular example happens to be someone who had health insurance (Medicaid, from the government) and couldn't get health care (a dentist), due in part to incompetent management of that insurance (cancellation due to failure to maintain current addresses). Basically it is a counter-argument to what you want to say.

Sloppy dishonesty is not going to contribute to finding health care solutions.

If you're pulling out the distorted sob stories you have definitely lost the argument Mr. Klein. Tell the truth please. Medical and dental professionals do not hold sick people hostage in acute situations. It is not part of the oath. We will send them a bill afterwards ?? ... sure probably but the horror stories of people getting turned away are a myth propagagted by the media and an insult to the hard working professionals who provide the highest quality health care on this planet. I have a newsflash for you. Hospitals are required to have medical professionals on call EVERY DAY AND NIGHT for emergencies whether someone is insured or not. If the aforementioned parents had just walked to the nearest hospital the young boy would be alive and well. Instead they blew it off until it was too late. As with most unfortunate situations in this country it comes down to personal responsibility. Unfortunately young Deamonte did not get a vote so why don't you grow up and stop the distortion ... or is that asking too much ... ???

30 million, 40 million, 50 million uninsured. Sally Pipes in her book "The Truth About Obamacare" disputes this number. She indicates the number is 8 million. 8 million is about 2.5% of the population. So the question is, do we need to radically socialize our system for 2.5% of the population?

I know, if you are a Liberal, the answer is yes. If you are Conservative, the answer is no.

John Ayanian, a professor of medicine and health-care policy at Harvard Medical School, testified before Congress on this issue. “Uninsured adults are 25 percent more likely to die prematurely than insured adults overall,"

Dr. Ayanian, how do you come to this number? What do they die of? How do they die? A little more on specifics please. I am tired of experts throwing around dire numbers. Yes, if you have a bad disease and you do not get it treated, you are going to die. Duh. I see people with insurance do this. So it is a little more complicated than not having insurance.

The Urban institute indicates that 22,000 people died from not having insurance. That represents 0.007% of the population. 42,000 people die in automobile accidents per year. Should we ban cars? Again, should we completely revamp the system?

For those who are in favor of socializing medicine. What are you going to say when the government bureaucrat says no to your treatment? Don't think that is going to happen? Google Zeke Emanuel and tell me otherwise.

A lot more common sense discussion needs to be injected into this debate. Not horror stories of the few number of people that fall through the cracks. Because Obamacare is not going to cover 100% of the population. These horror stories will be there if Obamacare is fully enacted. I am a physician. There will always be people who do not get care. Regardless of their insurance. I see it everyday.

This conservative says, "Bravo, Ezra." Not because I agree with your conclusion, but because the points made in this piece is the point that never was debated. In jamming through healthcare, the Dems talked about all of the regulations clean up the acts of insurers. But the issue that they were too afraid to discuss honestly was the cost-benefit analysis of insuring the uninsured.
I, for one, believe that the case can be made for extending insurance coverage to the uninsured. But, says this heartless conservative, taxpayer-funded coverage does not necesssarily have to mean rich coverage. It can be, to use the complaint of the NY Times, "skimpier," so long as it is "adequate."
But that, Ezra, is anathema to the Dems. Dems want to outlaw basic plans like those that McDonald's offers to its workers, and they sure don't want relatively basic plans being offered to the uninsured.
Maybe the Dems are right, and maybe this is worth it. But let's at least have a debate about the numbers. Okay? Is that so hard?

It may have already been mentioned in these comments, but expanding coverage through Medicaid does nothing to actually get patients treated. The overworked doctors willing to take Medicaid rates are getting fewer and farther between. They already have full rosters, so they can't see more patients. That is why coverage expansions like this those in the ACA are so empty. To actually improve access in public programs ('care/'caid), rates need to go up, not down. That is a hard argument to make in this world of budget deficits. Instead, those of us with private insurance will continue to face premium increases as providers increase their charges to make up for the underpayments by public programs.

The problem for Klein, and I hope he reads some of these comments, is that the people are finding out the horrible facts about ObamaCare. Klein can shill for the Dems all he wants but the horrible ObamaCare facts just keep on coming.

The Senate Dems who are up for re-election in 2012 and Obama himself are going to be crushed as they continue to lie about the many negative provisions of ObamaCare.

Liberals somehow seem to translate "the plight of the uninsured" as "government must force everyone else to pay the insurance costs of the uninsured." The principal effect of this is to reward those too improvident, indolent, or irresponsible to manage their own affairs.

Why should those of us who earn our medical insurance by hard work at jobs that provide such insurance as a benefit, or pay for our own insurance, be forced to subsidise those who either do not work or refuse to pay for their own insurance? That simply isn't fair.

Are you kidding me Ezra. They should lock up his parents for murder. Dentist do take cash. Why didn't they take him to the dentist who even if they didn't have the cash I bet the dentist would have put them on a payment plan
These liberals never tire of these ridiculus anecdotal stories. Why stop at only the people of the USA there are billions of uninsured world wide, don't they deserve health care too?
And if you want some great anecdotal stories read the UK papers they are full of heart breaking stories of how with their national health care many people are dying because it's gotten so bad.

Are you kidding me Ezra. They should lock up his parents for murder. Dentist do take cash. Why didn't they take him to the dentist who even if they didn't have the cash I bet the dentist would have put them on a payment plan
These liberals never tire of these ridiculus anecdotal stories. Why stop at only the people of the USA there are billions of uninsured world wide, don't they deserve health care too?
And if you want some great anecdotal stories read the UK papers they are full of heart breaking stories of how with their national health care many people are dying because it's gotten so bad.

The tragedy for Deamonte's family is that they had to rely on Medicaid, which like many goverment programs does a very bad job. Medicaid couldn't even keep eligible families enrolled (either because they skimp on administrative costs or no one was motivated to keep the Drivers enrolled). The tragedy for the uninsured, which Ezra Klein in his naive faith in big government overlooks, is that Obamacare would put most of them on Medicaid.

To the person who stated his insurance has skyrocketed to $ 4,000.00 per year, just wait until this bill kicks in. I own a small business in Massachusettes, before Massachusettes pased its form of obamacare I paid about $ 650.00 per month per individual for a family plan for myself and my employees. In the last few weeks I have beeen requesting different quotes from numerous Massachusettes health carriers because the cost has skyrocketed since the health reform bill passed in Ma. about 5 years ago, the best quote I recieved was $ 1,675.00 per family per month.
This is not a caddilac plan, it has a $ 500.00 dollar deductible per ind. and $ 2,000.00 per family deductible, copays and is considered in Ma. a mid range plan. Oh and my son and daughter went to the dentist a couple of times in the last two months for rutine procedures (fillings cleanings. It cost about $ 1,300.00 out of my pocket. This mid range plan does not cover any dental. I dont have to provide health insurance in Ma. because I only have 11 employees, its getting to the point where I will have to tell them to just get insurance on there own thru the mass health connector, unfortunately it wont be any cheaper for them, but at this point I dont have much choice. Its either that or just close the doors.

Europe is ripping apart at the seams from decades of unfunded entitlement promises they knew they couldn't keep, and you're still telling us how great the EU is and how we should imitate them and pile on our own entitlements as if the poor old fiddler isn't ever going to demand his sixpence. He's at the door, and he's getting angry.

Demographics is destiny, y'all. (Just put the y'all in so y'all liberals could make fun of the accent, even though I'm from Wisconsin...cause I know how much you enjoy putting down us unwashed classes.)

Libs, we didn't exactly learn about the baby boom epidemic yesterday, demographically speaking. We could have prepared for this. Every day for the next 18 years, starting Jan. 1, upwards to 10,000 boomers turn 65 and are eligible for medicare, not to mention the social security we've been eligible for since '08. That will gobble up government funds like a pig who hasn't been fed in a month. (Figured Mr. Klein would enjoy the rural metaphor, as he's no doubt an enviro with his own hand-planted organic garden like most of my conservative friends.)

California is looking at upwards of $750 billion in unfunded liabilities as are other blue states to lesser degrees, all stuffed like holiday turkeys with promises any fool could have told them wouldn't be edible.

Does Mr. Klein think it's a coincidence that the three biggest blue states, Illinois, New York, California are in the deepest economic doodoo?

Liberalism is collapsing around your thick heads and y'all stand there and carp about conservatives being against entitlements and not caring about starving babies. When the money's all gone, the money's all gone...that's not too complicated to get, is it? Especially when it's you who's been spending it.

How about the other half of that equation: if we can stop this runaway train before the money's all gone, maybe we won't all have to suffer?

Beyond comprehension. This must be how civilizational collapse occurs; when part of a culture that's up to its neck in denial continues to deny what's playing out in full view of its stunned gaze.

At least Nero had either the wry humor or perhaps the class to play his violin as Rome burned, instead of sitting there in a self-induced coma staring at the ceiling.

I actually get more information from reading all the comments to Ezra's story. Personally, I see two very dedicated camps of people entrenched in their positions about healthcare. Those that want government to take other peoples money to provide healthcare services they think everyone should have. And the other camp, that wants to keep their money and spend it on the services they think they need for themselves and their family.

Why can't all the people that want government to take other peoples money, just get their own system, give the government all their money, let the government distribpute it as they see fit......and leave the rest of us alone to fend for ourselves? I'd be more than happy to sign up for the "leave me alone" camp; I'll fend for myself, or suffer the consequences.

Seriously, have two systems. Those that want government to have total control, and another that doesn't want government interferance. It could be done. Make people choose which camp they are going to be in, and that's that. No turning back once the decision is made.

Okay, hopefully you get the joke! We have two systems today, one the government provides (Medicare and Medicaid), and the free market system. Which one is having the most problems providing services? The government one. Which one are the doctors fleeing from? The government one. Which one provides the best quality of care? Hint, it is not the government one.

Wake up people, having the government take control seems like a land of sunshine and lollypops, but it really a swamp of snakes and alligators. Repeal and replace Obamacare before it's too late. American's deserve better than Obamacare.

Times have been tough since Weigel exposed our e-mail list. We have spent months looking for a new way to distribute talking points, and while some of you still want to go the Twitter route, it’s a little too public for most of us. I think this blog will provide the perfect cover. Nobody reads it any more, so it’s basically as private and secure as our e-mail; perhaps more so. Better still, if we ever are exposed, I’m told that any big link shuts down the site immediately and completely, so we’ll have our embarrassing material hidden even faster than if I tried to wipe it off our servers.

Today’s agenda is, of course, Sarah Palin’s interview on Hannity last night. Joe Scarborough has the “why is she making it about her?” angle covered well at Politico (safe link here):

We get it, Sarah Palin. You’re not morally culpable for the tragic shooting in Tucson, Ariz. All of us around the “Morning Joe” table agree, even if we were stunned that you would whine about yourself on Facebook as a shattered family prepared to bury their 9-year-old girl.

Beyond that, the big story is, of course, the phrase “blood libel.” We have a choice between “she failed to address blood libel” and “she addressed blood libel badly” this morning. Which tack we choose depends, to some extent, on whether she actually addressed it or not. I can’t force myself to watch the clip, but Boehlert has volunteered to watch and let us know. The only problem is, Boehlert is kind of a liar, so do we have any other volunteers to check and see which line we should use? The clips are below:

Ezra, you can spin it any way you want. The fact remains that Deamonte Driver died as a result of parental neglect.

Don't bother with the crocodile tears about how the parent(s) could not afford to have the tooth extracted. The cost for extracting a tooth is minimal and one that millions of Americans routinely pay for themselves. The notion that not having insurance caused this child's death is a disgusting distortion of the truth and a blatant attempt to politicize a totally inexcusable death.

I remember Deamonte! He was brought to the ER by his 25-year-old mom, Chlamydia(She had him when she was 13). He was brought in with his four younger brothers: Leamonte, Neamonte, Teamonte and da'Rel. They had snotty noses and looked as though their teeth had never been brushed. She bought them each a bag of Hot Fries and a strawberry pop from the vending machine ($3.25 each) I remember her well, because she had a fancy hairdo, 2" acrylic nails and a bedazzled cellphone, which she kept next to her cigarettes. Two things struck me: 1) Even though every child in my state is automatically eligible for Medicaid, these children had not been enrolled; and 2)She was very demanding for someone with no means to pay her bill. Something else funny...there was no father listed as next of kin. Sad...he seemed like a sweet kid... kept asking about his grand mama and how he mostly "stay with her."

Dear Mr. Klein, There are lots of ways to play on people's emotions. It's reprehensible. I'll apologize if you will.

let me see.... I get to pay much higher taxes so someone can have dental insurance, even though my insurance doesn't cover dental problems. Thank you.

One big advantage of national health care is that you can force all the morons who receive it to do a monthly drug test. You fail, no benefits. Now let me see, which of the many democratic senators are willing to get that bill into motion!

Of the two Republican’s possibilities for replacement, Ryan's Roadmap 2.0 plan, and Boehner's "Common Sense" plan, neither would, on CBO analysis, cover anywhere near the 30+ million who would be covered under the PPA. (The Common Sense plan is estimated to cover only 3 million.) Each contains invitations to very RISKY choices. It's important to point out that the Roadmap, is non-longitudinal, i.e., it fails to depict (or leave an ordinary American with an adequate safety net for) any of the "Badlands" in a 70 year adulthood, working and investing for 40 years for a 30 retirement (badlands: asset bubbles, budget busting large wars with severe inflation, market crashes and massive job losses, severe unanticipated illnesses or accidents.) Both plans would leave most Americans MORE at risk than the current safety net. Also, the Roadmap is future-loaded with deep cuts for our children when they reach adulthood. Opposition to health care extension started out appealing to selfish Bad Samaritanism. Now in the Republican plans it invites us to become like Kronos, eating our own children to avoid tax increases for the rich.

>>For those who are in favor of socializing medicine. What are you going to say when the government bureaucrat says no to your treatment?<<

For those who are in favor of the status quo in the US: what are you going to say when the private insurance company functionary says no to your treatment due to preexisting condition (or whatever other reason they come up with)?

Here in Japan, certain treatments are approved under national health insurance; some are not. If you demand to have a kind or level of treatment that isn't covered, then you pay via additional private insurance, or out of pocket. National health insurance isn't meant as a panacea to cover every possible treatment a doctor somewhere may suggest. It's meant to cover the basics for the most people in the most economical and fairest way possible. That's one reason countries like Japan have better infant mortality and life expectancy rates than the US.

A large percentage of that 30 million are people who don't want insurance and the government is now forcing them to buy insurance. What if I just want to pay for a doctor's service? Lots of people just pay cash for doctor's services and save money on insurance. Health insurance isn't really insurance at all. It covers all sorts of optional things. It is like having insurance on your house to replace wall paper, or broken sprinklers, or even to put in sod (such as the case for cosmetic surgery). If someone wanted that kind of insurance on his house, he could get it, but it would cost a fortune. Maybe we should take a step back and ask what kind of insurance do we really need? And why should the government be involved in setting standard levels of coverage? Health care is not a basic right as the left ignorantly argues.

"But to repeal the bill without another solution for the Deamonte Drivers of the world?"

There is no solution for the Deamonte Drivers of the world in the PPACA. He was already on Medicaid. That is all the PPACA offers him. Nothing more.

The sad truth is that with or without the PPACA, Deamonte would have died any way. If you had read the article to which you link, you would already know that.

Maybe if we can get the two parties to work together, instead of shutting the other party out and going it alone, we can get rid of the current monstrosity and put in its place something that really would have saved Deamonte.

Even if I were to accept your 30 million uninsured figure, which I don't, does it not strike you in the last bit silly to fundamentally remake the best health care system in the world to solve a problem in one segment of the population? But, we can never let a crisis go to waste, can we Mr. Klein? No, the goal of Obamacare was always to build a system which would obliterate the private insurance sector's profit and replace it with, you guessed it, GOVERNMENT RUN HEALTHCARE!!

Even if I were to accept your 30 million uninsured figure, which I don't, does it not strike you in the last bit silly to fundamentally remake the best health care system in the world to solve a problem in one segment of the population? But, we can never let a crisis go to waste, can we Mr. Klein? No, the goal of Obamacare was always to build a system which would obliterate the private insurance sector's profit and replace it with, you guessed it, GOVERNMENT RUN HEALTHCARE!!

Obamacare makes it impossible for doctors to start a private hospital. Hundreds of such hospitals won't be built if Obamacare stays in place. Tens of thousands whose lives would have been saved at these institutions will die. They will die because Obama and the Democrats want power far more than they want to save lives. Obamacare is about government power not about health care.

"Perhaps Americans do not WANT to be a " charity case " , perhaps they want to proudly walk into a doctors office with a Health Insurance Card , and be treated like a human being , not a pariah."

You're kidding right? Being given an insurance card you didn't work to pay for doesn't make you an less of a charity case. Exactly what is it they are so proud of? Ben Franklin said the best way to get people out of poverty is to make them uncomfortable in their poverty.

"Perhaps Americans do not WANT to be a " charity case " , perhaps they want to proudly walk into a doctors office with a Health Insurance Card , and be treated like a human being , not a pariah."

You're kidding right? Being given an insurance card you didn't work to pay for doesn't make you an less of a charity case. Exactly what is it they are so proud of? Ben Franklin said the best way to get people out of poverty is to make them uncomfortable in their poverty.

"Perhaps Americans do not WANT to be a " charity case " , perhaps they want to proudly walk into a doctors office with a Health Insurance Card , and be treated like a human being , not a pariah."

You're kidding right? Being given an insurance card you didn't work to pay for doesn't make you an less of a charity case. Exactly what is it they are so proud of? Ben Franklin said the best way to get people out of poverty is to make them uncomfortable in their poverty.

Ezra, you know as much about healthcare in America as you know about the Constitution, which is to say, you are ignorant on both topics. The child died because his parents-or whatever caretakers he had- were too stupid to take him to an emergency room. No amount of health insurance cures stupidity. Just like no amount of Ivy League credentials can make you smart.

If the liberals are so concerned about the uninsured, let them pay for it. There is nothing stopping the liberals from getting out their checkbooks and solving the problem. Stop using the government to do your charity work.

I like others must have a question here . How on earth does this far leftist fruitcake keep his Job at the post ?
First he was the head of 100 Journalist that backed Obama omitting the facts plus he said the Constitution was too old to understand .

I like others must have a question here . How on earth does this far leftist fruitcake keep his Job at the post ?
First he was the head of 100 Journalist that backed Obama omitting the facts plus he said the Constitution was too old to understand .

I like others must have a question here . How on earth does this far leftist fruitcake keep his Job at the post ?
First he was the head of 100 Journalist that backed Obama omitting the facts plus he said the Constitution was too old to understand .

I like others must have a question here . How on earth does this far leftist fruitcake keep his Job at the post ?
First he was the head of 100 Journalist that backed Obama omitting the facts plus he said the Constitution was too old to understand .

The post is a sick Joke keeping this far left nut on their staff !
He headed the Obama 100 so called far leftJournalist blockage against facts on his back ground and sadly said The Constitution is to old to understand stupidity .

The post is a sick Joke keeping this far left nut on their staff !
He headed the Obama 100 so called far leftJournalist blockage against facts on his back ground and sadly said The Constitution is to old to understand stupidity .

If we didn't have 4.9 Million Illegals in prison plus 20 Million Illegals getting free health care , Welfare , subsidized housing and food stamps maybe we could have had the money to saved her son .
Or Tooth brushing twice a day would have done the trick .
We see happening in Africa daily because of lack of simple brushing ..Toilet paper is another important issue there by the way .
Causing hand food poisoning there as well .
Africa makes No Toilet paper as does Mexico making very little as well .

If we didn't have 4.9 Million Illegals in prison plus 20 Million Illegals getting free health care , Welfare , subsidized housing and food stamps maybe we could have had the money to saved her son .
Or Tooth brushing twice a day would have done the trick .
We see happening in Africa daily because of lack of simple brushing ..Toilet paper is another important issue there by the way .
Causing hand food poisoning there as well .
Africa makes No Toilet paper as does Mexico making very little as well .

It is sadly within Kline's marxist political beliefs . That all should be treated equal . EQUALLY POOR !
Yet his beloved Unions and the far left heath care bill set up many different Govt. standards for care and health care tax evasion . 222 Unions to date got Cad. health care tax pass's .
Facts -If the mother would have taken the child in dire needs to and emergency hospital he would have to have been treated because that is a 50 state Fed. law !
Most dental wings are part of the main hospitals since many gun shot wounds are to the Jaws , teeth mouth and face .
How do I know ? My Son is a Dr. in and emergency ward Hospital here in DC . 59 % of their care is for none Health care policy holders by the way . Making those with health care pay through the nose with triple cost for rooms while the patient beside them gets a free bed and care .

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